{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T02:04:57Z","timestamp":1762999497168,"version":"3.37.3"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T00:00:00Z","timestamp":1559692800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1033740"],"award-info":[{"award-number":["OPP1033740"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Severe adverse events after treatment with ivermectin in individuals with high levels of Loa loa microfilariae in the blood preclude onchocerciasis elimination through community-directed treatment with ivermectin (CDTI) in Central Africa. We measured the cost of a community-based pilot using a test-and-not-treat (TaNT) strategy in the Soa health district in Cameroon.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Based on actual expenditures, we empirically estimated the economic cost of the Soa TaNT campaign, including financial costs and opportunity costs that will likely be borne by control programs and stakeholders in the future. In addition to the empirical analyses, we estimated base-case, less intensive, and more intensive resource use scenarios to explore how costs might differ if TaNT were implemented programmatically.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The total costs of US$283 938 divided by total population, people tested, and people treated with 42% coverage were US$4.0, US$9.2, and US$9.5, respectively. In programmatic implementation, these costs (base-case estimates with less and more intensive scenarios) could be US$2.2 ($1.9\u2013$3.6), US$5.2 ($4.5\u2013$8.3), and US$5.4 ($4.6\u2013$8.6), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>TaNT clearly provides a safe strategy for large-scale ivermectin treatment and overcomes a major obstacle to the elimination of onchocerciasis in areas coendemic for Loa loa. Although it is more expensive than standard CDTI, costs vary depending on the setting, the implementation choices made by the institutions involved, and the community participation rate. Research on the required duration of TaNT is needed to improve the affordability assessment, and more experience is needed to understand how to implement TaNT optimally.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz461","type":"journal-article","created":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T19:11:09Z","timestamp":1559589069000},"page":"1628-1635","source":"Crossref","is-referenced-by-count":12,"title":["A Test-and-Not-Treat Strategy for Onchocerciasis Elimination in Loa loa\u2013coendemic Areas: Cost Analysis of a Pilot in the Soa Health District, Cameroon"],"prefix":"10.1093","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-4371","authenticated-orcid":false,"given":"Edeltraud J","family":"Lenk","sequence":"first","affiliation":[{"name":"Erasmus School of Health Policy and Management, Erasmus University Rotterdam"},{"name":"Department of Public Health, Erasmus Medical Center, University Medical Center Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henri C","family":"Moungui","sequence":"first","affiliation":[{"name":"Centre for Research on Filariasis and Other Tropical Diseases, Yaounde, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Boussinesq","sequence":"first","affiliation":[{"name":"Unit\u00e9 Mixte Internationale, TransVIHMI, Institut de Recherche pour le D\u00e9veloppement, University of Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kamgno","sequence":"first","affiliation":[{"name":"Centre for Research on Filariasis and Other Tropical Diseases, Yaounde, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugues C","family":"Nana-Djeunga","sequence":"first","affiliation":[{"name":"Centre for Research on Filariasis and Other Tropical Diseases, Yaounde, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Fitzpatrick","sequence":"first","affiliation":[{"name":"Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Claire M M","family":"Peultier","sequence":"first","affiliation":[{"name":"Erasmus School of Health Policy and Management, Erasmus University Rotterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy D","family":"Klion","sequence":"first","affiliation":[{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A","family":"Fletcher","sequence":"first","affiliation":[{"name":"Department of Bioengineering, University of California, Berkeley"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas B","family":"Nutman","sequence":"first","affiliation":[{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien D","family":"Pion","sequence":"first","affiliation":[{"name":"Unit\u00e9 Mixte Internationale, TransVIHMI, Institut de Recherche pour le D\u00e9veloppement, University of Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannick","family":"Niamsi-Emalio","sequence":"first","affiliation":[{"name":"Centre for Research on Filariasis and Other Tropical Diseases, Yaounde, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William K","family":"Redekop","sequence":"first","affiliation":[{"name":"Erasmus School of Health Policy and Management, Erasmus University Rotterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan L","family":"Severens","sequence":"first","affiliation":[{"name":"Erasmus School of Health Policy and Management, Erasmus University Rotterdam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilma A","family":"Stolk","sequence":"first","affiliation":[{"name":"Department of Public Health, Erasmus Medical Center, University Medical Center Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,4]]},"reference":[{"key":"2020041000553904900_CIT0001","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s40249-016-0160-7","article-title":"Progress towards onchocerciasis elimination in the participating countries of the African Programme for Onchocerciasis Control: epidemiological evaluation results","volume":"5","author":"Tekle","year":"2016","journal-title":"Infect Dis Poverty"},{"volume-title":"Special programme for research and training in tropical diseases (TDR). 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